Over 5,000 people take part in research here every year. They help us to continually improve the treatments the NHS can provide and to ultimately improve patient outcomes. We are delighted to share with you some of our amazing volunteers who have shared their research journey with us...
GMC number: 6054876
Year & location of first qualification: 2002, Nottingham University
Specialty: Rheumatology
Clinical interests: Systemic sclerosis & Raynaud’s phenomenon, Digital vasculopathy in autoimmune rheumatic diseases, Connective Tissue Diseases, Interstitial Lung Disease and Pulmonary Arterial Hypertension
Secretary: Pamela Stone
Dr John Pauling BMedSci BMBS FRCP (Rheum) PhD
North Bristol NHS Trust and Honorary Senior Lecturer in the School of Translational Sciences at the University of Bristol
Dr John Pauling is a consultant rheumatologist at North Bristol NHS Trust and Honorary Senior Lecturer in the School of Translational Sciences at the University of Bristol. John was awarded the Arthritis Research Campaign Medal before qualifying from Nottingham University Medical School in 2002. In 2009 he was awarded the Dando fellowship, jointly funded by the Raynaud’s & Scleroderma Association and Royal College of Physicians. His PhD research helped John to develop an interest in outcome measures in systemic sclerosis (SSc) research, particularly in relation to peripheral microvascular dysfunction in scleroderma. He has developed and validated new methods for assessing digital vasculopathy including patient reported outcome instruments and laser-derived methods in Raynaud’s phenomenon (RP) and systemic sclerosis. John is a member of the EULAR Microcirculation study group and has contributed to recent initiatives of the UK Scleroderma Study Group. John has published over 130 peer-reviewed journal articles and several book chapters in the field of peripheral vascular disease and systemic sclerosis (h-index 30). He has presented at multiple international meetings.
Dr John Pauling sits on the executive committee of the Scleroderma Clinical Trials Consortium (SCTC) and leads the SCTC Vascular Working Group that is currently undertaking work to develop novel outcome measures for Raynaud’s phenomenon and digital ulcer disease in systemic sclerosis. He co-chairs the OMERACT systemic sclerosis special interest group. He leads the Raynaud’s taskforce for an NIH initiative to appraise outcome measures suitable for assessment by the FDA when considering clinical trials of SSc-RP. He also co-chairs the SCTC Industry Roundtable bringing together industry representatives and international scleroderma investigators to advance clinical trial design in SSc.
805 Clinical quality – clinical effectiveness
L Shaw; T Maggs; P Braude; D Shipway; S Srivastava; M Kelly
Upper limb fractures are the second most common fracture requiring admission to hospital after hip fracture [Jennison, 2019]. At 1-year 20.5% have died, compared to 29.5% in hip fracture [Wiedl, 2021]. Local Problems: At North Bristol Trust most patients with upper limb fractures and a Clinical Frailty Score ≥ 5 are managed non-operatively on medical wards. Local service evaluation identified a long length of stay of 23 days. Case note review revealed: ∙ Delayed transfers of care (DTOCs) had been managed non-weight bearing in slings for 4-6 weeks. ∙ Non-weight bearing status resulted in DTOC due to declined access to social care and rehabilitation due to perceived health needs. ∙ A high rate of hospital-acquired complications and failure to rehabilitate. ∙ Breakdown in interdisciplinary communication and ownership across the pathway.
A multidisciplinary QI project was commenced. Using local data through business analytics, clinician and patient feedback, a new Trust guideline was developed for older people with frailty and upper limb fractures. Data collected determined average length of stay before and after implementation of the service change. A standard process control chart was created monitoring the effect of the changes in the pathway. The multidisciplinary team met regularly to make alterations during implementation. The resulting intervention included: ∙ Removal of functional restrictions; allow free use of limb as comfort permits. ∙ Simplified slings and minimised light weight casts. ∙ Proactive integration of orthopaedic plan into CGA documentation. ∙ Proactive interdisciplinary communication across pathways. ∙ Patient information leaflets.
Pre-intervention average length of stay was 23 days. Post-intervention was 14 days.
Proactive, structured management of upper limb fractures in people with frailty is associated with significant reduction in acute hospital length of stay. Next steps include a business case for a frailty trauma specialist therapist embedded into medicine.
Additional thanks for ongoing support from Tahid Alam, Alasdair Bott, Andrew Riddick, Frances Verey, Lynn Hutchings, Nathanael Ahearn
Please use Badger Notes - Self-refer your pregnancy to BNSSG and complete the form to arrange your first appointment with a midwife at North Bristol NHS Trust.
We recommend you complete the Badger Notes form as soon as you know you are pregnant; it should take approximately 10 minutes to complete.
We will contact you within three working days to offer you an appointment, this will be at the most suitable time to ensure that you are booked for your scan and screening tests within a recommended timeframe.
Appointments are occasionally offered in a neighbouring area to ensure that your appointment is at the optimum time. The first appointment is important and we would appreciate your flexibility to attend the offered appointment.
If you need help completing this form, please contact the booking team, Monday to Friday between 08:00 and 16:00 on 0117 414 6743.
Some pregnant people may require an early appointment:
If so, in addition to completing the self-referral form, please contact the Screening team for early screening advice on 0117 414 6739.
You can find more information about Badger Notes on our dedicated page.
Kerry Than, Head of Patient Experience
Hello, we hope you enjoyed the summer sun and are looking forward to the cosy months ahead. It’s been an exciting few months in Patient Experience which we hope you enjoy reading all about!
I will be returning to Derby this month as Head of Patient Experience there whilst Emily rejoins you here. It’s been a joy to work at NBT and meet so many passionate people. I want to wish you all the very best as you take the next steps in the proposed merger. I truly believe that the benefits for patients, carers and everyone who uses our services will be invaluable. Together, we have a real opportunity to make care even better.
Earlier this month, we were delighted to bring people together for the very first meeting of the Bristol NHS Group’s Community Participation Group held at the Watershed in central Bristol.
This new group brings together people with lived experience of our services, local community networks, and voluntary organisations. United by a shared commitment to improving health and care, this group will help shape the future in line with our Joint Clinical Strategy.
Our first session was all about making connections, building trust, and starting to shape how we’ll work together. We also took time to explore the ambitions behind our Joint Clinical Strategy. It was a really positive and collaborative beginning to what we hope will be a long and meaningful journey.
We’re looking forward to sharing more as the group grows and continues to help shape a more inclusive, community-led approach to healthcare and service development.
We are excited and busy organising our Volunteer Thank You event taking place on the 1st November at BAWA. This event is our way of showing appreciation to our incredible volunteers. It’s a chance for them to come together with staff, share in the celebration, and feel truly valued. We’ll also be honouring those who’ve reached long service milestones with special awards - thank you for all that you do!
We were delighted to mark a special milestone for our Move Maker Volunteer Manager Jill, who recently celebrated 30 years of NHS service. Jill's leadership, dedication and passion for supporting Move Makers has a lasting impact on the experience of patients, visitors and staff. Thank you Jill, for three decades of outstanding service and commitment to making a difference.
Art on wards
This summer Fresh Arts worked with teams in antenatal, Cotswold ward and gynaecology cancer services to choose artwork to go into spaces in which difficult news is relayed to patients. A selection of tree and nature based photographic images provide a calming perspective beyond the space of these rooms which are sometimes windowless. We worked with the team on Gate 34B to choose artwork by Cath Read for their Relatives Room and ICU who chose uplifting artwork of local scenes by Jenny Urquhart to revamp their windowless Relatives Rooms.
Thanks to a generous donation to Southmead Hospital Charity by the family of a patient who sadly passed away on Gate 33B we worked with patients and staff to improve two patient bedrooms at end of the ward which are tucked into the corner of the building with a small, dark outlook. Inspired by a regular patient to Gate 33B, unable to leave her room she misses the outdoor spaces that nurture her wellbeing; patients and staff chose imagery of forests that were installed as floor to ceiling wall vinyls.
New artwork designed by Lynda Porter was installed on ceiling tiles and walls in 6 Resus Bays in ED. In addition, the Relatives Room and Rose Cottage have been completely revamped with a soft green wall paint and a collection of photographic prints and light boxes by Lynda Porter now enhance these spaces. Lynda was grieving the passing of her father when she created these works so these are a sensitive response to difficult times.
On 27 September, the Fresh Arts team and several members of the Patient Experience team took part in the 25km hike from Bristol to Bath with the aim of raising £10k for the Fresh Arts Programme. Please consider sponsoring us by donating here: https://southmeadhospitalcharity.enthuse.com/pf/team-fresh-arts
We recently filmed a patient story in the Macmillan Wellbeing Centre. We heard from several patients who shared how important, powerful and healing the craft sessions that volunteer Liz runs at the centre can be. Her paper flowers have also been used for a hospital wedding!
Chaplaincy Volunteers Training Course
The Chaplaincy team recently welcomed two familiar faces into new roles.
Firstly, Steve Christian has been appointed as Interim Lead Chaplain. Steve joined the team as a Chaplain 12 months ago and has now stepped into the lead role following Mark Read's retirement. We wish Steve the very best as he leads the team through their journey and helps to shape the service as part of the Hospital Group.
We also welcome Richard, who joined the chaplaincy team as a volunteer ward visitor in 2023 and has now become an honorary Chaplain. His new role will see him supporting patients and families at end of life, through maternity loss and supporting patients and families who experience trauma.
The Chaplaincy Team are based in the Sanctuary Area at Gate 30. They are available not just for patients and visitors but also for staff. They seek to help people of faith and none. If you're looking for a compassionate ear or assistance with religious or spiritual matters, please feel free to visit or reach out to the team on extension 43700. They're here to support you.
If you would like to request a pdf version of our study information, please email the Study team at: TTT@nbt.nhs.uk
This study is trialling a new method of caesarean birth called “Time-to-Transition". “Time-to-Transition” involves a slower caesarean birth, allowing the baby time to start breathing before it is fully delivered. We propose that this may reduce the chance of babies developing “wet lungs” which can cause breathing difficulty just after birth. We will film the births so we can learn from them. We will collect information about you and your baby, from your medical records.
We will ask you to complete some questionnaires about your birth experience and whether you or your baby have had any extra healthcare in the first month after birth. If you have a birth partner, they will also be invited to complete questionnaires about the birth.
We would like to invite you to take part in the Time-to-Transition Caesarean Birth Study. Please take time to read the information and discuss it with your friends and family. A member of the research team will be happy to answer any questions you may have.
This is a small-scale “feasibility” study, to help us test how the study will run, and to learn if a larger-scale study would be possible.
This study is testing the Time-to-Transition Caesarean Birth method (explained below), which has been developed by Obstetricians and Neonatologists at Southmead Maternity Unit.
We are offering participation in this study to all women who are:
Whilst in the womb, a baby’s lungs are filled with fluid, which helps them grow and develop. During labour and birth, most of this fluid goes away, as the baby transitions from life in the womb to breathing air. Some babies might take longer to clear this fluid after they are born, so the lungs can remain “wet” for longer, making it harder to breathe until the fluid clears. When this happens, babies breathe faster and shallower, a condition known as Transient Tachypnea of the Newborn (TTN) and they often need some additional help with breathing, antibiotics to prevent or clear infection, and sometimes a stay in a Neonatal Intensive Care Unit.
TTN is twice as common in babies born by planned caesarean than those born vaginally, as at caesarean births, babies are typically born very quickly and have less time to clear this fluid and transition to breathing air.
In this world-first study, we aim to assess a new way to perform a planned caesarean to increase the time that babies have to transition: a ‘Time-to-Transition Caesarean Birth’.
Rather than being born rapidly after opening the womb, the doctor will deliver the baby’s head and keep the body inside the womb until the baby starts to breathe or to cry, up to a maximum of 2 minutes, before delivering the baby fully. The birth will be filmed using two Hospital cameras. We will ask for your consent to be filmed. If you say no, we can film the birth in such a way that you will not be visible. You can still be involved in this Birth Partner study if you say no to being filmed.
Most of the preparation and aftercare of you and your baby will be the same as in a routine caesarean birth, but there are some important differences.
You can still have skin-to-skin and delayed cord clamping if you would like to. As with any caesarean birth, the mother and baby will be closely monitored and if there are any concerns the baby will be immediately delivered. Everything else about the birth and recovery afterwards will remain unchanged.
We don’t know if this new method is better than a routine caesarean birth. We hope that the Time-to-Transition birth will reduce the chance your baby will have wet lungs and are less likely to need help breathing, antibiotics, or a stay in NICU. But we can’t be sure. This study will help us find out.
For that reason, we don’t know if there will be any direct benefit to you or your baby, but you may be helping families in the future once the results of this study are known.
We don’t expect the Time-to-Transition birth will be riskier to you or your baby. You will both be monitored very carefully during, and after the birth. Your baby will be birthed immediately if there are any concerns about you or your baby.
We have designed the study to take as little extra time as possible. If you decide you would like to take part, this is what will happen.
The day you have your baby
The day after your baby is born
A month after your baby is born
If you have a birth partner, they can be present at your baby’s birth, just as they would if you weren’t part of the study. We will ask them for their consent to being filmed during the birth. If they say no, we will film the birth in such a way that they are not visible.
We would also like to invite them to be a part of the Birth Partner study which involves them completing the questionnaire about birth experiences after your baby is born. If they say no, you can still be involved in this study.
Yes, if you would like it, you can request a copy. You can still bring your own camera to take your own pictures on the day.
We don’t think your recovery time would be any different to if you were having a routine caesarean birth.
You will be cared for in the same way after the birth. More information about Caesarean birth and recovery can be found at
Caesarean Birth | North Bristol NHS Trust
(nbt.nhs.uk) or by watching this video
https://youtu.be/WEwH5WwMjoE
This study is being carried out by staff at North Bristol NHS Trust and the University of the West of England.
This study is funded by donations made to the Southmead Hospital Charity.
The Health Research Authority and South Central Berkshire Research Ethics Committee (B) REC: 23/SC/0228 IRAS project ID: 325202 have reviewed and agreed to this study.
If you are eligible and interested in learning more, a Research Midwife will talk to you and help you decide if you'd like to take part in this study. If you would still like to take part, they will ask you to complete a consent form.
You can change your mind and withdraw from this study at any time and without giving a reason, but we will keep information about you that we already have. If you do not want this to happen, tell us and we will stop. It will not affect the care that you receive, nor that of the person you are birth partner for.
We will ask you to let us know your preference by completing a study withdrawal form.
We need to manage your records in specific ways for the research to be reliable. This means that we won’t be able to let you see or change the research data we hold about you. If you agree to take part in this study, you will have the option to take part in future research using your data saved from this study.
All research in the UK, which uses patient information must follow UK law (the Data Protection Act) and GDPR* rules.
North Bristol NHS Trust (UK) is the Sponsor for this study. This means we are responsible for looking after your information and using it properly, according to the rules and law.
In this questionnaire study we will need to use some information about you. This information will include your name, contact details and some basic information such as your age and ethnicity. We will use your contact details to get in touch with you by phone, email, or text.
We will keep all information about you safe and secure. People who do not need to know who you are will not need to see your name or contact details. Your data will be given a code number instead. We will write our reports in such a way that no one can work out who took part in the study.
Once we have finished the research study, we will keep some of the data so that we can check the results. We will store study data for up to 5 years after the end of the project, as per standard protocol at North Bristol NHS Trust. We will write our reports in such a way that no one can work out who took part in the study.
(*GDPR stands for General Data Protection Regulation)
North Bristol NHS Trust is the sponsor for this study. You can find out more about how we use your information at:
Patient Data & Research Privacy Policy | North Bristol NHS Trust (nbt.nhs.uk)
www.hra.nhs.uk/information-about-patients.
You can also:
NHS-sponsored research such as this study is covered by NHS indemnity (the same indemnity that applies to any patient in the NHS). In the unlikely event that you feel you have been adversely affected by taking part in this study, you should contact the research team as soon as possible.
Should you wish to complain about any aspect of the way you have been approached or treated during the study, the normal NHS complaints mechanisms are available to you.
Please visit www.nbt.nhs.uk/patients-carers/feedback for further information about how to make a complaint or contact the North Bristol NHS Trust Hospital Patient Advice and Liaison Service (PALS): Telephone 0117 414 4569. PALS can also provide confidential advice and support to patients, families, and their carers.
The study is being led by Dr Joanna Crofts at Southmead Hospital (North Bristol NHS Trust). If you have any questions about the study please contact Dr Joanna Crofts, Consultant Obstetrician, Southmead Hospital either by:
The Study Email address: TTT@nbt.nhs.uk
Telephone: 01174146764
If you would like to request a pdf version of our study information, please email the Study team at: TTT@nbt.nhs.uk
The main study is testing the Time-to-Transition Caesarean Birth method, which has been developed by Obstetricians and Neonatologists at Southmead Maternity Unit.
Rather than being born rapidly after opening the womb, the doctor will deliver the baby’s head and keep the body inside the womb until the baby starts to breathe or to cry, up to a maximum of 2 minutes, before delivering the baby fully. The birth will be filmed using two Hospital cameras. We will ask for your consent to be filmed. If you say no, we can film the birth in such a way that you will not be visible. You can still be involved in this Birth Partner study if you say no to being filmed.
As you are the birth partner of someone who has agreed to take part in the Time-to-Transition Caesarean Birth study, we would like to invite you to take part too, by sharing your thoughts about your experiences of the birth. If you decide not to take part, the person who you are birth partner to can still be involved in the study.
There will not be any direct benefit to you in taking part, but you may be helping families in the future once the results of this study are known.
This is a questionnaire study and there will be no risk to you.
To find out more about the possible benefits or risks to the caesarean birth itself, please refer to the “Time-to-Transition Caesarean Birth Study” information leaflet. (where can this be found)??
If you agree to take part, we will ask you some questions about yourself (such as age and ethnicity).
We will also ask you to complete a short questionnaire about your experience as a birth partner to a participant of the main study
Each questionnaire will take about 5-10 minutes to complete, and can be done over the phone, or on a smartphone or computer if you have one.
This study is being carried out by staff at North Bristol NHS Trust and the University of the West of England.
This study is funded by donations made to the Southmead Hospital Charity.
The Health Research Authority and South Central Berkshire Research Ethics Committee (B) REC: 23/SC/0228 IRAS project ID: 325202 have reviewed and agreed to this study.
If you are eligible and interested in learning more, a Research Midwife will talk to you and help you decide if you'd like to take part in this study. If you would still like to take part, they will ask you to complete a consent form.
You can change your mind and withdraw from this study at any time and without giving a reason, but we will keep information about you that we already have. If you do not want this to happen, tell us and we will stop. It will not affect the care that you receive, nor that of the person you are birth partner for.
We will ask you to let us know your preference by completing a study withdrawal form.
We need to manage your records in specific ways for the research to be reliable. This means that we won’t be able to let you see or change the research data we hold about you. If you agree to take part in this study, you will have the option to take part in future research using your data saved from this study.
All research in the UK, which uses patient information must follow UK law (the Data Protection Act) and GDPR* rules.
North Bristol NHS Trust (UK) is the Sponsor for this study. This means we are responsible for looking after your information and using it properly, according to the rules and law.
In this questionnaire study we will need to use some information about you. This information will include your name, contact details and some basic information such as your age and ethnicity. We will use your contact details to get in touch with you by phone, email, or text.
We will keep all information about you safe and secure. People who do not need to know who you are will not need to see your name or contact details. Your data will be given a code number instead. We will write our reports in such a way that no one can work out who took part in the study.
Once we have finished the research study, we will keep some of the data so that we can check the results. We will store study data for up to 5 years after the end of the project, as per standard protocol at North Bristol NHS Trust. We will write our reports in such a way that no one can work out who took part in the study.
(*GDPR stands for General Data Protection Regulation)
North Bristol NHS Trust is the sponsor for this study. You can find out more about how we use your information at:
Patient Data & Research Privacy Policy | North Bristol NHS Trust (nbt.nhs.uk)
www.hra.nhs.uk/information-about-patients.
You can also:
NHS-sponsored research such as this study is covered by NHS indemnity (the same indemnity that applies to any patient in the NHS). In the unlikely event that you feel you have been adversely affected by taking part in this study, you should contact the research team as soon as possible.
Should you wish to complain about any aspect of the way you have been approached or treated during the study, the normal NHS complaints mechanisms are available to you.
Please visit www.nbt.nhs.uk/patients-carers/feedback for further information about how to make a complaint or contact the North Bristol NHS Trust Hospital Patient Advice and Liaison Service (PALS): Telephone 0117 414 4569. PALS can also provide confidential advice and support to patients, families, and their carers.
The study is being led by Dr Joanna Crofts at Southmead Hospital (North Bristol NHS Trust). If you have any questions about the study please contact Dr Joanna Crofts, Consultant Obstetrician, Southmead Hospital either by:
The Study Email address: TTT@nbt.nhs.uk
Telephone: 01174146764 - between 9 am to 4pm.